Project Summary Over the past 5 years, the Wake Forest Baptist Comprehensive Cancer Center (WFBCCC) has continued its upward trajectory in cancer research excellence and service to its catchment area. The WFBCCC catchment area includes the Piedmont and southern Appalachia, a region of 58 contiguous counties in North Carolina, Virginia, West Virginia and Tennessee. The majority of this region is rural and exhibits significant racial health disparities. Elevated age-adjusted smoking rates, obesity rates, cancer incidence, and cancer mortality are observed across the WFBCCC catchment area when compared with the rest of the U.S. To target these issues, the WFBCCC conducts cutting-edge basic, clinical, and population research on the prevention, detection and treatment of cancer, and translates this knowledge into strategies to improve patient outcomes and reduce the incidence of cancer. WFBCCC cancer research funding is $37.9 million, of which over $14.9 million comes from the NCI; this represents a 25.3% increase in total cancer funding since the last CCSG renewal. Center research space under the Director?s authority increased by approximately 65,000 square feet, and the WFBCCC clinical facilities have been dramatically enhanced with the completion of the new eleven- story Cancer Hospital in 2013. This building houses all oncology inpatients and outpatients. The Center?s 127 members span the basic, clinical and population sciences and are organized into 4 Programs with substantial inter-and intra-programmatic productivity. Faculty additions enhanced tobacco control, tobacco-related cancer research, and precision medicine. Substantial investment in faculty, technology, and informatics significantly expanded cancer genomics capabilities. Enrollment of patients into treatment trials reached an all-time high in 2015, with a large increase in the number of patients enrolled in investigator-initiated trials. WFBCCC population scientists initiated exciting new efforts in cancer prevention and survivorship. Clinical scientists completed practice-changing studies in patients with glioma and lung cancer. Groundbreaking observations in prostate cancer emerged from WFBCCC inter-programmatic collaborations. WFBCCC basic science Programs continued to make high impact observations that are being translated into human therapeutics. The WFBCCC requests continued CCSG funding for 4 scientific Programs; 7 Shared Resources; 2 clinical research components; administration and leadership; planning and evaluation; and developmental funds. With these funds, a talented faculty integrated throughout the Cancer Center will make advances in the prevention, early detection, and treatment of cancer in the WFBCCC catchment area and the nation.